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APPLICA'�f'il,N FnR CONSTRUCti �ON PERI►!!!T � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT ���T <br /> L HEATING SYSTEM: J GAS J ELECTRIC J ._._._____ <br /> BUILDING DEPARTMENT � O <br /> 259-8810 �Ph7 �-/������y/� /U2�-O,�-'�7�j1�' :v �:Jt�i C� �Q� ��=�7�.5(.J i,:: . <br /> DEMOLITION COMBINATIbN BUILDING MECHANICAL _PLUMBING _SIGN <br /> r�r.�s r,�mi nnc�+css cnr � ziv vHove <br /> q /� i <br /> �1YY-� Nln!f` E%ss.,ner.Pu'� i;-� %� z� �E�Ar�r� �- F<%� �. 'l�— .�,��''- %/C�- <br /> CBlANI IAAILAppRE5C CILV IIP 1'NONE <br /> �5 i .Y ,s;�,�f'l� ,�u� <br /> RRCNIIEGTOROESIGNER MAILADOR[55 CITV 21P PHONE <br /> GLl1FlIRlCONiPALTON// hIPiLRDDPE55 CRV / 2iP PNOYE SLAtE4CEN5E• ��r4� <br /> ���.-,�< l�/�a��: �� Co.v.57` //9c'/ ��d� f/E_ .5r ��/-/� 7yJ=0"Lf'n J�%�r ,iL;r e <br /> VI.GVANiCAICONiNACiOR MnILADDRE55 qiY 21P PNONE STATEUCENSE� <br /> e_ <br /> H (�-)y� �i\ � <br /> �L PIU�iaGCONiRPGTOF IAAILAUDRCSS CIiV ZIP PIIONE STAL[LICENS[• <br /> ltl <br /> H <br /> ��y ,LfSSOFWOPK - <br /> NEW ADDITION `yCALTERATION REPAIR DEMO'_'�TION WOODSTOVErFRPL INSERT BUILDING RELOCATION <br /> �y ,1 LO iA6i GERSON AND FIIONE/N9_� � �/ <br /> ki y � (:JNiRAGTPRIC[OFIVORK �• I lJ_Ci�-U ���, /irYT F�/L�!-__�S �vZ.S_n <br /> O �'O ��`+���BE WORK ANDSOIIRR[FOOTAGE INVOI ED <br /> � �"I � <br /> y ~r i>rnroseouseoFOm�oiNc � HEREBY CERTIFV THAT I HAVE READ AND EXAMWED THIS <br /> �7.3 APPLICATION AND KNOW 1 HE SAh1E TO F3E TRUE AN�CORRECT.ALL <br /> plrJ <br /> HC �mnioescairnorvocPaovEarv�sr�owNee�o�voanitneerouacoaiesi PROVISIONSOFLAWSANDORDINANCESGQVERNINGTHISTYPEOF <br /> O H WORK WILL DE COA1PLETED WITFI WHETHEF SPECIFIED HEREIN OR <br /> N �C ior e�ock or _ NOT. THE GRANTING OF A PERMIT DOES NOT PqESUME TO GNE <br /> �� n AUTHORITV TO VIOLATE OF CANCEL THE PROVISIONS OF ANV <br /> M G OTHER STATE OF LOCAL LAW REGl1LATING CON51 RUCTION OR THE <br /> x y � - PERFORh1ANCE OF CONSTFUCTION.THAT I AM AUTNOR12ED B�1HE <br /> r y OWNER OF THIS PROPERTV TO PERFORM THE tNORK FOfl WHICH <br /> h'� H 1PPLICATION IS MADE AND I COAIPLV WITH THE STATE <br /> N <br /> ��y CONTRACiORS lAW 7827 RCW AN 296.200 WAC. <br /> � y (�A _ — x_s:_„��___�.�CCa.�-wc..'.�� I 'l- / L_ <br /> H] � (p :nOJEGi RD�RF55 ' <br /> �31 $ Snn i`�'v --,.-., ,—,. `, --- — --- <br /> � PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(1PILET� �� �C-A HNDLC UNIiS-H F <br /> _ ___ __-__ ._ — __-__-_-._ <br /> � BATHTUB FORCED NR S�STEI.IS-B.TL. t.7 E.A. <br /> � �� _ LAVATOFiV6VASHBASIN) UNITHEAT[FS-[3.T.LL A1 _ <br /> � SHOWER CLOTHES DRVEflS <br /> � KITCHEN SWK 8 DISP VENTILATION FAN � <br /> -�- <br /> DISHWASHER RANGE HOOD <br /> • LAUNDRYTFAV WATER HEATER <br /> I __ CLOTHES WASHER WOO�STOVE _ _ <br /> URINPL h1ETAL FIREPLAC[8 CHIMNEY <br /> DRINNING FOUNTAIN FIREPLACE INS[RT I <br /> — _ --�-_ <br /> '�, FLOUR DRAIM — HEAT PU61? - <br /> _' BACHFLCJJ PREVENTERS GAS PIPING <br /> �� ROOF DRAINS-RAINLEADERS EXHAUST FAN _ <br /> SINK ISERVICE-BAR,ETC.) <br /> � �1 — - <br /> —;--- <br /> SUB TOTAL 5 SUB TOTAL 5 _ <br /> =1�' PERMIT 5 _ PERMIT 5 <br /> TOTALFEE 5 TOTALFEE S ,� <br /> FOR OFFICE USE ONLY: <br /> �RJNTSEi8A0K (�FAfISEi�PGK 5@ESfiitlAGK ANC�IEC�(�J �'9Ht �fL Rb,C[iPINO <br /> _ll.;�l2 <br /> usezoHfl �otae[n VACRNi51TE FEES VALUATION FEE <br /> 9UILDING '1 �� _� <br /> hi`I:OICONiS.ALIOWABI[ IYCEOttON9ALtUAI ocmwsc. vonorv4i�xauuns -- —��—"`-'�— <br /> °"a' pLUlAOING <br /> S'.'E oF BLOG. NOAF SiORiES &15EMENT MECNANICFL <br /> CCCIIPANLYLOAD FIRESPflNKLER5RE00 HEIGHTIIMIiAfION �1�OIilONALPLFNLHECK — <br /> SPRINKLER <br /> R[ASONfORSPFINNLEPS - - r <br /> STATE 6UILDING SURCHAHG[ �G� <br /> q -- �____ <br /> u�t�kr.nv v�nrus� ruqvcnnv CITYOFEVERETT rusuCwoaKs <br /> � �-� LOCAL SALES � <br /> � ;�;-� TAX CODE IS 3105 totA� % ��� <br />